Expanded Program on Immunization (Philippines)

The Expanded Program on Immunization (EPI) in the Philippines began in July 1979. And, in 1986, made a
response to the Universal Child Immunization goal. The four major strategies include: [
1.

sustaining high routine Full Immunized Child (FIC) coverage of at least 90% in all provinces and cities;

2.

sustaining the polio-free country for global certification;

3.

eliminating measles by 2008; and

4.

eliminating neonatal tetanus by 2008.

Routine Schedule of Immunization

Wednesday is designated as immunization day and is adopted in all parts of the country. Immunization is done
monthly in barangay health stations, quarterly in remote areas of the country.
Routine Immunization Schedule for Infants[
The standard routine immunization schedule for infants in the Philippines is adopted to provide maximum immunity
against the seven vaccine preventable diseases in the country before the child's first birthday. The fully immunized
child must have completed BCG 1, DPT 1, DPT 2, DPT 3, OPV 1, OPV 2, OPV 3, HB 1, HB 2, HB 3 and measles
vaccines before the child is 12 months of age

Vaccine

Bacillus
CalmetteGurin

Minimum
Minimum
Number
Age
Dose
Interval
of Doses
at 1st Dose
Between Doses
Birth or
anytime
after birth

1 dose

0.05
mL

DiphtheriaPertussisTetanus
Vaccine

6 weeks old 3 doses

0.5
mL

Oral Polio
Vaccine

6 weeks old 3 doses

2-3
drops

Hepatitis B
Vaccine

At birth

3 doses

0.5
mL

Route

Site

Reason

BCG given at earliest

possible age protects the
Right deltoid
possibility of TB
none
Intradermal region of the
meningitis and other TB
arm
infections in which
infants are prone
Upper outer
6 weeks(DPT
portion of the An early start with DPT
1), 10 weeks
Intramuscular thigh, Vastus reduces the chance of
(DPT 2), 14
Lateralis (L- severe pertussis.
weeks (DPT 3)
R-L)
The extent of protection
against polio is increased
the earlier the OPV is
4 weeks
Oral
Mouth
given.
Keeps the Philippines
polio-free.
4 weeks interval Intramuscular Upper outer An early start of
portion of the Hepatitis B vaccine
thigh, Vastus reduces the chance of
Lateralis (R- being infected and

L-R)

Measles
Vaccine
(not MMR)

9 months
old

1 dose

0.5
mL

none

becoming a carrier.
Prevents liver cirrhosis
and liver cancer which
are more likely to
develop if infected with
Hepatitis B early in life.
About 9,000 died of
complications of
Hepatitis B. 10% of
Filipinos have Hepatitis
B infection

Upper outer
At least 85% of measles
portion of the
Subcutaneous
can be prevented by
arms, Right
immunization at this age
deltiod

General Principles in Infants/Children Immunization

Because measles kills, every infant needs to be vaccinated against measles at the age of 9 months or as
soon as possible after 9 months as part of the routine infant vaccination schedule. It is safe to vaccinate a
sick child who is suffering from a minor illness (cough, cold, diarrhea, fever or malnutrition) or who has
already been vaccinated against measles

If the vaccination schedule is interrupted, it is not necessary to restart. Instead, the schedule should be
resumed using minimal intervals between doses to catch up as quickly as possible.

Vaccine combinations (few exceptions), antibiotics, low-dose steroids (less than 20 mg per day), minor
infections with low fever (below 38.5 Celsius), diarrhea, malnutrition, kidney or liver disease, heart or
lung disease, non-progressive encephalopathy, well controlled epilepsy or advanced age, are not
contraindications to vaccination. Contrary to what the majority of doctors may think, vaccines against
hepatitis B and tetanus can be applied in any period of the pregnancy.

There are very few true contraindication and precaution conditions. Only two of these conditions are
generally considered to be permanent: severe (anaphylactic) allergic reaction to a vaccine component or
following a prior dose of a vaccine, and encephalopathy not due to another identifiable cause occurring
within 7 days of pertussis vaccination

Only the diluent supplied by the manufacturer should be used to reconstitute a freeze-dried vaccine. A
sterile needle and sterile syringe must be used for each vial for adding the diluent to the powder in a single
vial or ampoule of freeze-dried vaccine

The only way to be completely safe from exposure to blood-borne diseases from injections, particularly
hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) is to use one
sterile needle, one sterile syringe for each child.

Tetanus Toxoid Immunization Schedule for Women[

When given to women of childbearing age, vaccines that contain tetanus toxoid (TT or Td) not only protect women
against tetanus, but also prevent neonatal tetanus in their newborn infants.
Vaccine

Minimum

Percent

Duration of Protection

Age/Interval
TT1

TT2

TT3

TT4

TT5

At 20th weeks AOG

At least 4 weeks later

At least 6 months
later

At least 1 year later

At least 1 year later

Protected
0%

protection for the mother for the first delivery

infants born to the mother will be protected from neonatal

tetanus

gives 3 years protection for the mother

infants born to the mother will be protected from neonatal

tetanus

gives 5 years protection for the mother

infants born to the mother will be protected from neonatal

tetanus

gives 10 years protection for the mother

gives lifetime protection for the mother

all infants born to that mother will be protected

80%

95%

99%

99%

In June 2000, the 57 countries that have not yet achieved elimination of neonatal tetanus were ranked and the
Philippines was listed together with 22 other countries in Class A, a classification for countries close to maternal and
neonatal tetanus elimination.
Care for the Vaccines[
To ensure the optimal potency of vaccines,a careful attention is needed in handling practices at the country level.
These include storage and transport of vaccines from the primary vaccine store down to the end-user at the health
facility, and further down at the outreach sites.[ Inappropriate storage, handling and transport of vaccines wont
protect patients and may lead to needless vaccine wastage.[
A "first expiry and first out" (FEFO) vaccine system is practiced to assure that all vaccines are utilized before its
expiry date. Proper arrangement of vaccines and/or labeling of expiry dates are done to identify those close to
expiring. Vaccine temperature is monitored twice a day (early in the morning and in the afternoon) in all health
facilities and plotted to monitor break in the cold chain. Each level of health facilities has cold chain equipment for
use in the storage vaccines which included cold room, freezer, refrigerator, transport box, vaccine carriers,
thermometers, cold chain monitors, ice packs, temperature monitoring chart and safety collector boxes.